title: Causes of death in HIV-infected patients from the Cologne-Bonn cohort.
abstract: OBJECTIVE
  Causes of death in human immunodeficiency virus (HIV)-infected subjects have changed in countries with high resources over the last several years. Acquired immunodeficiency syndrome (AIDS)-related diseases have become less prevalent, whereas deaths due to non-AIDS causes are increasing. The aim of the present study was to analyse causes of death in the Cologne-Bonn cohort.
  
  
  METHODS
  Causes of death from the Cologne-Bonn cohort between 2004 and 2010 were systematically recorded using the CoDe algorithm (The Coding Causes of Death in HIV Project).
  
  
  RESULTS
  In 3,165 patients followed from 2004 to 2010, 182 deaths occurred (5.7 %, 153 males, 29 females). The median age at the time of death was 47 years (range 24-85 years). The most frequent causes of death were AIDS-defining events (n = 60, 33 %), with non-Hodgkin lymphoma (NHL) (n = 29, 16 %) and infections (n = 20, 11 %) being the leading entities in this category. Non-AIDS malignancies accounted for 16 % (n = 29), non-HIV-related infections for 10 % (n = 18), cardiovascular diseases for 7 % (n = 14), suicide or accident for 4 % (n = 7) and liver diseases for 3 % (n = 5) of deaths (unknown n = 47, 26 %). Although the majority of patients (92.5 %) was on antiretroviral therapy (ART), only 50 % were virologically suppressed (HIV-RNA <50 copies/mL) and 44 % had a decreased CD4+ count (<200/μL) at their last visit before death.
  
  
  CONCLUSIONS
  One-third of the causes of death in our cohort between 2004 and 2010 was AIDS-related. Since most of these deaths occur with severe immune suppression, they can possibly be prevented by the early diagnosis and treatment of HIV infection. Care providers must be aware of an increased risk for a broad range of diseases in HIV-infected patients and should apply appropriate preventive measures.
authors.affiliation: First Department of Internal Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany, kathrin.ehren@uk-koeln.de.
authors.forename: K
authors.initials: K
authors.lastname: Ehren
authors.forename: C
authors.initials: C
authors.lastname: Hertenstein
authors.forename: T
authors.initials: T
authors.lastname: Kümmerle
authors.forename: J J
authors.initials: JJ
authors.lastname: Vehreschild
authors.forename: J
authors.initials: J
authors.lastname: Fischer
authors.forename: D
authors.initials: D
authors.lastname: Gillor
authors.forename: C
authors.initials: C
authors.lastname: Wyen
authors.forename: C
authors.initials: C
authors.lastname: Lehmann
authors.forename: O A
authors.initials: OA
authors.lastname: Cornely
authors.forename: N
authors.initials: N
authors.lastname: Jung
authors.forename: S
authors.initials: S
authors.lastname: Gravemann
authors.forename: M
authors.initials: M
authors.lastname: Platten
authors.forename: J C
authors.initials: JC
authors.lastname: Wasmuth
authors.forename: J K
authors.initials: JK
authors.lastname: Rockstroh
authors.forename: C
authors.initials: C
authors.lastname: Boesecke
authors.forename: C
authors.initials: C
authors.lastname: Schwarze-Zander
authors.forename: G
authors.initials: G
authors.lastname: Fätkenheuer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult